How to Balance the Live Birth Rate and the Multiple Pregnancy Rate by Selecting the Cleavage-stage Embryo Number and Quality for POSEIDON Group 1 and Group 2? A Retrospective Study

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2024 Dec 16

PMID 39680145

Authors

Huiqing He

Rang Liu

Qiuju Zhang

Lan Geng

Zhenhui Hou

Chang Xu

Yanpei Cao

Xi Xia

Affiliations

Soon will be listed here.

Abstract

Purpose: For unexpected low-prognosis patients (Group 1 and Group 2) defined by POSEIDON criteria, how to maximize the live birth rate while controlling the multiple birth rate by tailoring the embryo transfer number and quality?

Methods: This was a retrospective study, including patients from Poseidon Group 1 (N = 672) and Group 2 (N = 503) who underwent cleavage-stage embryo transfer. Logistic regression was used for the comparative analysis of clinical outcomes among subgroups divided by the number and quality of embryos.

Results: For Group 1, compared to transferring a single good-quality embryo (GQE), a good-quality embryo with a poor-quality embryo (GQE + PQE) did not significantly improve the live birth rate, although increasing in value (40.5% vs 31.9%, P = 0.272), meanwhile obviously raised the multiple birth rate to 28.1% (P = 0.042). For Group 2, double embryo transfer (DET) was associated with a higher live birth rate than single embryo transfer (SET) (22.4% vs 6.3%, P = 0.001) and further analysis indicated that the similar trend observed in the GQE + PQE group compared to the GQE group (26.1% vs 8.5%, P = 0.017) with statistical significance, but without a significant increase in the multiple birth rate (8.3%, P = 1.000).

Conclusions: The study indicated that a single good-quality cleavage-stage embryo was an option for patients in Poseidon Group 1 to avoid the risk of multiple pregnancies. DET with mixed quality cleavage-stage embryo might be an alternative for Poseidon Group 2, given that it improved the pregnancy outcomes while controlling the multiple birth rates.

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